March 2009

Seamless integration for quality care : Rakesh Budhe, Asst. General Manager (Sales & Marketing) Softlink International

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Healthcare delivery has evolved dramatically in the last decade or so, but the same cannot be said about Healthcare IT (HIT).

There used to be a time when for speciality surgical procedures and treatments Indians would travel overseas, this trend was later followed by people travelling to metros for similar treatments. Now tier-2 and 3 cities are gaining ground and super-speciality hospitals are coming up across the country and major healthcare providers have big plans to set up hospitals in various corners of India. Healthcare delivery has evolved dramatically in the last decade or so, but the same cannot be said about Healthcare IT (HIT).

Major Original Equipment Manufacturers (OEMs) are now shipping equipment that are compliant to standards such as DICOM and HL7, as well as sharing information with the industry but hospitals need to deploy IT solutions that make this information and images portable across various stakeholders within and outside the hospitals such as doctors, administrators, paramedics, insurance provides etc.

Even though there is a lot of progress on the HIT front, one will still find major hospitals across india have “islands” of information that can not be interconnected resulting in manual transportation of data diluting efficacy of automation. In the last 2-3 years hospitals have started understanding the importance of HIT and started giving due importance to HIT that it deserves.

The technology for acquiring, storing, retrieving, displaying, and distributing medical images and patient information has changed dramatically in the last few years. The new buzzword is ‘enterprise solution’ in medical image and information management solutions, wherein, digital images from radiology, cardiology, and many other imaging modalities are seamlessly linked with information from clinical information systems and other databases, and they are accessed seamlessly from a single point.

One of the issues that plagued the progress of hospital information system / radiology information systems / picture archiving and communication systems (HIS/CIS/PACS) integration was a matter of language between Health Level-7 (HL7) and DICOM. The broker solved this barrier – a software and hardware device that accepts HL7 messages from the HIS and RIS then translates the data to produce DICOM messages for transmission to the PACS. The broker provides support for patient and exam information from the RIS to flow to the modality with the help of DICOM modality work list. With DICOM protocols the patient images generated on the medical equipment are transferred to PACS. These patient images in PACS has seamless integration with clinical information systems and/or Hospital Information System.

Inspite of having standards and communication protocol, fully integrated HIS/RIS/PACS from different vendors is an expensive process in terms of time, of implementation and interfacing fees charged by multiple vendors. System integration is significantly hampered, not by technological limitations, but by business and political issues.

In response to these challenges, few companies like SoftLink have begun to offer ‘seamlessly integrated’ commonly termed ‘Broker Less’ RIS/PACS solutions and/or HIS/RIS/PACS solutions. These significantly improved solutions, achieve better ‘workflow automation’ as all the products that are required to create the solution are offered by a single vendor. Apart from backend integration, these solution also allows front-end integration and thus provides ‘single log in’ into HIS/RIS/PACS solution, making information and images accessible to healthcare providers.

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